右美托咪定滴鼻联合七氟醚吸入对小儿腹腔镜疝修补术患儿镇静镇痛效果及应激反应的影响  

Effect of Dexmedetomidine Nasal Drops Combined with Sevoflurane Inhalation on Sedation,Analgesia,and Stress Response in Children Undergoing Laparoscopic Hernia Repair Surgery

作　　者：梁娜 王媛 李瑜 贾英萍 Liang Na;Wang Yuan;Li Yu(Anesthesiology Department,Henan Children’s Hospital Zhengdong Branch,Zhengzhou,Henan,451161,China)

机构地区：[1]河南省儿童医院郑东院区麻醉科,河南郑州451161

出　　处：《黑龙江医学》2025年第7期820-822,共3页Heilongjiang Medical Journal

摘　　要：目的:分析右美托咪定滴鼻联合七氟醚吸入对小儿腹腔镜疝修补术患儿镇静镇痛效果及应激反应的影响。方法:选取2022年5月—2023年5月于样本医院接受腹腔镜疝修补术的96例腹股沟疝患儿作为研究对象。采用随机数表法将其分为对照组和试验组,每组各48例。给予试验组患儿鼻内滴入右美托咪定联合七氟醚吸入,给予对照组患儿七氟醚吸入麻醉。比较两组患儿手术相关指标、镇静效果、应激反应[肾上腺素(AD)、去甲肾上腺素(NE)、C反应蛋白(CRP)、超氧化物歧化酶(SOD)]、镇痛效果[视觉模拟评分法(VAS)]、术后麻醉不良反应情况。结果:试验组患儿麻醉苏醒时间、麻醉复苏时间、行为评分、运动评分及镇静评分低于对照组,差异均有统计学意义(t=6.473、6.565、6.367、5.696、4.672,P<0.001)。试验组患儿AD、NE升高浮动趋势较小、恢复较快,差异均有统计学意义(F=9.362、11.269、12.594、16.085、7.117、9.173,P<0.001)。术后1 d,试验组患儿CRP、SOD低于对照组,差异均有统计学意义(t=4.981、3.690,P<0.05)。清醒后30 min、术后3 h、术后12 h,试验组患儿VAS评分低于对照组,差异均有统计学意义(t=6.913、4.082、10.542,P<0.05)。结论:小儿腹腔镜疝修补术使用右美托咪定滴鼻联合七氟醚吸入具有较强的镇静镇痛效果,围术期应激反应轻微,可促进术后早期苏醒,麻醉不良反应少。Objective:To analyze the effects of dexmedetomidine nasal drops combined with sevoflurane inhalation on sedative,analgesic and stress response in children undergoing laparoscopic hernia repair.Methods:96 children with inguinal hernia in Zhengzhou Children’s Hospital were selected as the study objects.All the children received laparoscopic hernia repair in the hospital.The selection period is from May 2022 to May 2023.According to different anesthesia methods,48 cases were divided into each group.The experimental group was given dexmedetomidine combined with sevoflurane inhalation,and the control group was given sevoflurane inhalation anesthesia.The indexes related to surgery,sedation effect[University of Michigan Sedation Scale(UMSS)],stress response[adrenaline(AD),norepinephrine(NE),C-reactive protein(CRP),superoxide dismutase(SOD)],analgesia effect[visual analogue scale(VAS)]and postoperative anesthesia adverse reactions were compared between the two groups.Results:The anesthesia recovery time,anesthesia recovery time,behavioral scores,exercise scores and sedation scores of experimental group were lower than those of control group,and the differences were statistically significant(t=6.473,6.565,6.367,5.696,4.672;P<0.001).The two groups showed a smaller upward and downward trend and a faster recovery in the experimental group,with statistically significant difference(F=9.362,11.269,12.594,16.085,7.117,9.173;P<0.001).1 day after operation,CRP and CRP in experimental group were lower than those in control group,and the difference was statistically significant(t=4.981,3.690;P<0.05).The VAS score of experimental group was lower than that of control group 30 min after waking up,3 h after surgery and 12 h after surgery,and the difference was statistically significant(t=6.913、4.082、10.542;P<0.05).Conclusion:The use of dexmedetomidine nasal drops combined with sevoflurane inhalation in pediatric laparoscopic hernia repair has strong sedative and analgesic effect,mild perioperative stress reaction,which can promote

关 键 词：腹股沟疝 腹腔镜疝修补术 右美托咪定 七氟醚 镇静镇痛 应激反应 

分 类 号：R614[医药卫生—麻醉学]